Hepatic Sclerosing Hemangioma Mimicking Malignancy: A Case and Literature Review

Tian Li¹, Miriam M. Klar¹, Mouyed Alawad², Rishard Abdul¹, Ayesha Zahiruddin³, Moro O. Salifu¹ and Isabel M. McFarlane^1,

¹Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203

²Department of Pathology, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203

³Department of Gastroenterology and Hepatology, VA NY Harbor Health Care System- Brooklyn Campus

Cite this paper

Tian Li, Miriam M. Klar, Mouyed Alawad, Rishard Abdul, Ayesha Zahiruddin, Moro O. Salifu and Isabel M. McFarlane. Hepatic Sclerosing Hemangioma Mimicking Malignancy: A Case and Literature Review. American Journal of Medical Case Reports. 2021; 9(3):144-146. doi: 10.12691/AJMCR-9-3-2

Abstract

Background: Sclerosing hemangiomas of the liver are rare, benign tumors with degenerative changes. These degenerative changes, however, often obscure the true, benign nature of the tumor and give them features indistinguishable from other malignant processes, thus making the diagnosis difficult. Case presentation: A 70-year-old male without any previously diagnosed liver disease or malignant process presented with incidental right hepatic mass in ultrasonography and weight loss. Physical exam was unremarkable. The labs were significant for mild pancytopenia, elevated total bilirubin and slightly decreased transferrin. Follow-up triple phase-contrast CT scan of the abdomen revealed a lobulated, poorly demarcated lesion measuring 4.8 x 4.5 cm, located in segment V of the liver with encasement of the left portal branch. The overall picture was indeterminate but highly suspicious for malignancy. A decision was made to perform a CT-guided biopsy which revealed sclerosing hemangioma of the liver. Conclusion: It is challenging to differentiate sclerosing hepatic hemangioma from atypical hepatocellular carcinoma, intrahepatic cholangiocarcinoma, and metastatic tumors utilizing only imaging modalities. The diagnostic workup should include biopsy of the atypical liver lesion which unveils the final diagnosis and avoid subjecting the patient to an extensive, and invasive surgical resection.

Keywords

hemangioma, sclerosing, liver, imaging features

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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